Please fill out the application completely and thoroughly. Information collected are used for (1) contact for sitting sessions, (2) our record-keeping and background checks, (3) our organizational impact and demographic analysis, and (4) externally ONLY IN AGGREGATE, without revealing any personal information; primarily used for grant-seeking purposes. Your personal information is protected and all information obtained will be kept confidential and may only be used in accordance with the provisions of applicable federal laws, executive orders, and regulations. Only information necessary for the sitting session will be shared with families such as names, contact numbers and relevant information made available on your sitter profile. Information such as your name, photo and sitting session feedback may be used for outreach and grant-seeking purposes. In the unlikely event that we may want to use the information provided for other purposes, consent will be sought from you directly.
Please input NA if the question is not relevant to you.
If you have questions or concerns about the form, please contact our Family Coordinator at firstname.lastname@example.org.
Thank you for taking your time to fill in the form!